How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,698 to $9,772Professionalmedian $1,230 · 10th to 90th $933 to $1,905
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,202.26 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,318.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $4,073.80 Typical High $5,888.44 | Facility | None | $1,412.54 | $4,073.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,949.84 | Professional | None | $933.25 | $1,000.00 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $25.70 Median $933.25 Typical High $1,737.80 | Professional | None | $25.70 | $933.25 | $1,737.80 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $1,548.82 | Professional | None | $19.05 | $19.05 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,047.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,691.53 | Professional | None | $831.76 | $1,047.13 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,162.28 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,230.27 | $1,778.28 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $870.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $831.76 |
Where Nevada sits
The same service costs 5.0 times more in Colorado than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $14,731KY $2,968
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.